Diet and Tooth Decay
The foods you eat and the beverages you drink can have a direct influence on the incidence and progression of tooth decay, depending upon:
- The form of the food—whether it’s liquid, solid, sticky or slow to dissolve makes a difference.
- How often you eat sugary foods and beverages and how often you eat or drink acidic foods and beverages.
- The nutritional makeup of the food.
- The combination of the foods you eat and the order in which you eat them.
- Medical conditions you may have, such as gastrointestinal reflux and eating disorders, which can increase risk of cavities and weaken teeth.
The bacteria in your mouth use carbohydrates for food, so when you cut back on sugar, and other sources of simple carbohydrates that are easily fermentable, you reduce your cavity risk. Limit added sugars in your diet by reading food labels to determine the amount of added sugar in a food. Since ingredients are listed on the label in order of weight, from most to least, if one of the following terms is listed as one of the first few ingredients, it’s a good bet that food is high in sugar.
Any sugar (beet, brown, cane, confectioners', demarara, powdered, invert, palm, turbinado, raw, crystallized cane, yellow, etc.), Any syrups (corn, high fructose corn, malt maple, Carob, Sorghum, rice, buttered, etc.), Agave nectar, evaporated cane juice, barley malt, cane crystals, cane juice, caramel, corn solids, corn sweeteners, dextrin, dextrose, diastic malt,
diatase, ethyl maltol, evaporated can juice, fructose, fruit juice concentrate, lactose, glucose, honey, maltodextrin, maltose, molasses, panocha, saccharose, sorbitol, surcrose, treacle, etc.
Top Sources of Added Sugar in the Diet and Percentages
- soft drinks, energy drinks, sports drinks, 35.7%
- grain-based desserts (cakes, pies) 12.9%
- fruit drinks 10.5%
- dairy-based desserts (ice cream) 6.5%
- candy 6.1%
- ready-to-eat cereals 3.8%
- sugars and honey 3.5%
- tea (sweetened) 3.5%
- yeast breads 2.1%
- all other foods 15.4%
The USDA has a website for further nutritional information on diet www.chosemyplate.gov
pH and Oral health
A healthy mouth should have saliva register at approximately 7.0 pH (neutral). The pH scale ranges from 1 (acidic) to 14 (alkaline). When you eat foods containing sugar the bacteria in your mouth use the sugar to produce acid as a waste product. This causes the pH in your mouth to lower to a level that softens enamel in less than five minutes. When the pH drops below 5.5 the enamel starts to demineralize which may result in tooth decay. The longer and more frequently the pH remains below 5.5 the more harmful it is to your tooth structure. Fortunately, you have saliva to wash away the acid and remineralize and repair the teeth
with new calcium and phosphate. It takes approximately 20 to 90 minutes for the pH to return to normal levels.
Removing the plaque and residual particles in your mouth from the foods you eat will help reduce the acid challenge to teeth that results in decay.
Saliva acts as a constant rinse in the mouth, therefore, cleansing the entire oral cavity. People with less saliva, or dry mouth, are more susceptible to cavities.
Re-mineralization of a tooth or teeth occur at 7.5 pH or higher. This is where your teeth rebuild enamel.
People can have acidic saliva and their own saliva damages their enamel. The more acidic your mouth is the more frequently you will need to use neutralizing mints, sprays, etc.
The most confusing detail is that a few foods that alkalize the body are acidic to the mouth such as lemons and spinach. Lemons have such a low pH that they can soften and demineralize the teeth. Spinach contains oxalic acid that can erode the pellicle on teeth in turn making your teeth sensitive. When eating lemons or spinach incorporate foods that include calcium which binds with the oxalate. Conclude the meal with xylitol or other pH balancing mints, chewing gum, or mouth sprays.
People with bad gums and periodontal disease often have a kind of bacteria in their mouth that affects their taste buds, making water unpalatable. If you dislike water and have gum disease, try adding a teaspoon of xylitol into water and drink this, in place of soda, for a week. You may find your taste buds recover and your desire for soda is reduced. Eliminating soda altogether will be beneficial for your gums, teeth and overall health.
Tooth Decay Prevention Guidelines
The following behavior will decrease your risk of tooth decay:
- Brush your teeth with an electric powered rechargeable tooth brush (Sonicare and Oral-B brushes recommended) for 2 minutes, 2-3 x/day, after every meal, minimum of morning and evening.
- Use ADA approved over the counter tooth paste (i.e.Crest, Colgate) for low decay risk.
- Floss a minimum of 1x daily, after last meal, 2-3 x/day best.
- Swish daily with a Fluoridated OTC mouthwash, (i.e. ACT, Fluorigard, Crest Pro Health with Fluoride, Listerine Total, Colgate or Rembrandt with Fluoride.
- Limit acidic (low pH) beverages and fermentable carbohydrates (sugars) in diet,
(i.e. Coke, Pepsi, lemon lime soda, lemonade, Gatorade, sports drinks, Hi-C, citric acid flavored soda water, fruit juices, sweetened dried fruits, candy).Omit between meals.
- Brush with prescription strength Fluoride-Calcium-Phosphate tooth paste; Clinpro 5000 1-2 x/day, as directed to control moderate risk of decay, expectorate do not rinse.
Clean between the teeth and stimulate the gum tissues daily with the following options; (Soft-Piks, proxybrushes, Stim-u-dents, plastic toothpicks,
- rubber tip gum stimulator, end-tufted toothbrush, Waterpik / water flosser etc.), Superfloss / floss threaders (if needed i.e. around bridges and splints.)
- Chew gum with Xylitol; Ice Cubes gum has 1 gram/piece, chew for 5-20 minutes 6-8/day not to exceed 10 per day. ADA approved Trident (also with Recaldent), Spry gum/mints, ACT lozenges or Zollipops after meals, acidic beverages and snacks. Acts as an antibacterial lowering the risk of tooth decay neutralizing the acidity and stimulating salivary flow in the oral cavity.
- Basic Bites - Chews that maintain a healthy neutral pH in the oral cavity.
- Custom fluoride trays 5-10 minutes/day ideal with prescription Prevident, NaF or Gel Kam, SnF.
- Prescription MI Paste with Recaldent contains bio-vailable Calcium, Phosphate - minerals from which tooth structure is comprised and Fluoride. Apply cream 3-4x/day as directed to remineralize and strengthen teeth to become more resistant to decay -control high risk.
- Chlorhexidine prescription mouth rinse 2x daily for 1 week each month as directed.
- Professional Varnish Fluoride treatment with dental cleanings at 3-4 month intervals.
- Oral lubricant/saliva substitutes/pH neutralizers: Professional prescription -
GC Dry Mouth Gel, OTC -Oasis Spray with Xylitol, -ACT Total Care.
- Use buffering products like sodium bicarbonate (baking soda) toothpaste and gum.
- Smoking cessation (smokefree.gov).